the pulsepoint study

Conditions: Out-Of-Hospital Cardiac Arrest; Heart Arrest; Heart Diseases; Cardiovascular Diseases

Summary: this randomized controlled trial will evaluate whether use of the pulsepoint system increases bystander cpr or defibrillator use compared to standard dispatch procedures in patients who suffer non-traumatic, out-of-hospital cardiac arrest in a public location. half of all suspected cardiac arrest 9-1-1 calls in a public location will receive pulsepoint alerts (treatment arm). the other half of this eligible patient cohort will receive standard dispatch procedures (control arm).

out-of-hospital cardiac arrest (ohca) is a major public health problem. more than 45,000 canadians suffer ohca annually, with only 8.4% surviving to hospital discharge. early bystander cardiopulmonary resuscitation (cpr) and defibrillator use can save lives but are rarely done. advances in mobile device technology have allowed the development of a system which can notify cpr-trained citizens within 400 meters of a possible cardiac arrest. the pulsepoint mobile device application (www.pulsepoint.org) empowers them to respond and provide basic life support while professional crews are being dispatched. when a mobile device receives the alert data from the pulsepoint system, the application presents a map showing the exact location of the emergency and the closest public access defibrillator. pulsepoint will be implemented in 2 regions across canada and the us (british columbia and columbus, ohio). after a coordinated marketing campaign in each participating region to maximize the number of mobile device application downloads in the community, 9-1-1 calls for suspected cardiac arrest will be randomized to conventional dispatch for suspected cardiac arrest versus conventional dispatch plus pulsepoint notifications. the primary outcome will be bystander cpr or defibrillator use prior to professional responders arriving on scene. the primary analysis will involve comparing outcomes between the control and treatment groups among randomized patients who satisfy inclusion and exclusion criteria and have at least one pulsepoint responder within 400 meters of the cardiac arrest event. the investigators hypothesize that the pulsepoint system will have an immediate impact on increasing bystander cpr and defibrillator use in participating communities. in the long term, this project will provide valuable data on how effective pulsepoint is with respect to bystander resuscitation and survival. the data will directly inform policy decisions about pulsepoint implementation in the participating communities and guide other north american jurisdictions around these policy decisions in the future.

Eligibility criteria:
inclusion criteria: 1. patients with 911 calls assigned as "suspected" or "confirmed" cardiac arrest and, 2. are confirmed to be ems-treated, public location out-of-hospital cardiac arrest. exclusion criteria: 1. traumatic cardiac arrest, or 2. cardiac arrests occurring in the context of a dangerous scene as determined by the 9-1-1 call-taker, or 3. ems-witnessed cardiac arrest, or 4. cardiac arrests not treated by ems ("do not resuscitate", signs of obvious death), or 5. cardiac arrests occurring in nursing homes and health care facilities.

Keywords: cardiac arrest cardiopulmonary resuscitation automated external defibrillators smartphones